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Histopathology of acneiform eruptions in patients treated with epidermal growth factor receptor inhibitors

Lindsey A Brodell1, Donna Hepper, Anne Lind

  • 1Barnes Jewish Hospital, Washington University in St. Louis, St. Louis, MO, USA.

Journal of Cutaneous Pathology
|August 15, 2013
PubMed
Abstract

Insights

Epidermal growth factor receptor inhibitors (EGFRIs) cause acneiform eruptions. Histopathology reveals neutrophilic folliculitis, aiding diagnosis of this common EGFR inhibitor side effect.

Area of Science:

  • Oncology
  • Dermatology
  • Pathology

Background:

  • Epidermal growth factor receptor inhibitors (EGFRIs) are anticancer drugs used for solid tumors.
  • EGFRIs commonly cause cutaneous adverse events, notably a follicular papulopustular (acneiform) eruption.

Purpose of the Study:

  • To elucidate the histopathologic findings of acneiform eruptions induced by EGFRIs.
  • To compare findings with prior published case series.

Main Methods:

  • Histopathological examination of 10 patients with EGFRIs-induced papulopustular eruptions.
  • Comparison with four previous case series on EGFRIs-induced acneiform rashes.

Main Results:

  • All 10 patients exhibited superficial, neutrophilic suppurative folliculitis.
  • Ectatic follicular infundibula and epithelial lining rupture were observed.
  • Similar histopathologic findings were consistent across all reviewed case series.

Conclusions:

  • The characteristic clinical appearance often negates the need for biopsy.
  • Understanding histopathology enhances knowledge of the pathophysiologic process.
  • Dermatopathologists must recognize this pattern as EGFRIs use expands.
Keywords:
dermatologydermatopathologyhair follicle

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